Introduction: The advent of Microinvasive Glaucoma Surgery (MIGS) offers a novel approach in the treatment of glaucoma with the number of procedures developing at an exciting pace. MIGS procedures aim to lower intraocular pressure (IOP) via: (1) increasing trabecular outflow, (2) increasing outflow via suprachoroidal shunts, (3) reducing aqueous production, and (4) subconjunctival filtration. Areas covered: A comprehensive search for published studies for Microinvasive Glaucoma Surgery (MIGS) devices or procedure was undertaken using PubMed. Search terms included ‘minimally invasive glaucoma surgery’, ‘microincisional glaucoma surgery’, and ‘microinvasive glaucoma surgery’. A manual search for each device or procedure was also performed. After review, randomized control trials and prospective studies were preferentially included. Expert commentary: These procedures offer several benefits: an improved safety profile allowing for intervention in earlier stages of glaucoma, combination with cataract surgery, and decreased dependence on patient compliance with topical agents. Established MIGS procedures have proven efficacy and more recent devices and procedures show promising results. Despite this, further study is needed to assess the long term IOP-lowering effectiveness of these procedures. Particularly, rigorous study with more randomized control trials and head-to-head comparisons would allow for better informed clinical and surgical decision-making. MIGS offers new solutions for glaucoma treatment.
Orbital fractures comprise about 25% of facial fractures1 and led to an estimated 250,379 emergency department (ED) visits in the US from 2006 to 2017.2 They remain a major reason for ophthalmologi...
30 January 2022 in Journal of Academic Ophthalmology
Objective The aim of the study is to describe an inexpensive and easily-constructed model eye for the purpose of teaching laser peripheral iridotomy (LPI) and selective laser trabeculoplasty (SLT) to ophthalmology residents. Methods Easily constructed, inexpensive model eyes were utilized to teach residents SLT and LPI utilizing a remote self-study module. A teaching microscope attachment allowed for video-based instruction and feedback. Results This model eye, used in conjunction with video modules is an effective low-cost teaching tool for laser surgery among ophthalmology residents. Attending ophthalmologists rated the use of these model eyes using surveys and found them to be appropriate teaching tools that could lead to improved knowledge and translate to better patient care. Conclusion Our novel method for teaching glaucoma laser surgery allows residents to learn the principles and theory behind common laser procedures while having the opportunity to practice repetitive procedures on low-cost model eyes.
The prevalence of vision impairment and eye disease is higher among patients with chronic kidney disease (CKD), yet there are no standardized guidelines for this vulnerable population. We hypothesized that there are self-reported unmet ophthalmic care needs among patients receiving hemodialysis. We also hypothesized that limited awareness of the connection between eye health and CKD is a significant barrier to receiving eye care. Methods: From June 2022 to July 2022, patients on dialysis were recruited in-person at two Independent Dialysis Foundation sites in Baltimore, Maryland. Participants completed a survey assessing recent eye exam history, barriers to care, and health literacy. Results: Of 82 participants, 43 (52%) had not received a complete eye exam within the past year. The most common reasons were scheduling conflicts (15 [35%]), not wanting an eye exam (12 [28%]), and costs (6 [14%]). Less than half of respondents (40, 41%) were unaware of a relationship between kidney disease and eye health. Conclusions: Results suggest potential unmet eye care needs and low awareness of CKD-related ocular risks among dialysis patients. Interventions to enhance provider recommendations, improve health literacy, and reduce logistical barriers may help prevent avoidable vision loss in this high-risk population.